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AF - 38002,� � Da�; June 6��968 ,•�•.' •�?� City of Fridley, Minr- BUILDING PERMIT B��r Homedale Bldrs. ,p�� ,d� 5217 T�la,yzata Blvd. LOCATIdN OP BUILDING No. 7424- street .� Concerto Curve _._.._ part of Lot N� �� so Lot 11 __ Block � Addition or Sub-Divisian .� Me� Q.r3jr Mg,.nor ;�d Coraer Lot � Inside Lot x Setback � 3 5� �_ Sideyard — �� Sewer IIevation _.._� 88„7.2� � 890.27 ��pA�ox.� Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 46` Depw �4 28 xe�ght —20 sq. Ft. � � 52 c�u. Ft ._ Front Depth _._. Height _._.. Sq. Ft. _.._.. Cu. P't. '!j►pe of ConetruCtfoII ---�.'�� Fs� Cost —.....��.8�8�-_ To be Completed (lr.-F.n�har 1 AHA SEWER LOCATION - 11' West of Ma;.nY�.ole W,ATII� LOC�TION - 1' West of Ma:nhole In con�deration of the issuance to me of a germit to construct the buildiug described above I a�ree to do the proposed work in accordance with the descrlption above set forth aad in compliance with a�l provlaions of ordiaances of the dty oE FrTdley. �100.00 Sewer Connection. Charge Ea conafderation of the payment of a fee of $ 35'�� , perrmit fs hereby granted to g�medale Builders to construct the buflding or addition as d�cribed above. Thiap�� t ia granted upoa the �expr�a condition that the person to whom it is granted and his agents, employees anc� worl�nen. in all work dane in, around and u�n said buflding, or any part tt►ereof, shall conform in all respects to the or�►ance� of Fridley, 1liinaesota regardfug locatfon, construction, alteration, maintenance� repair and mov3ng of buil�ings within the dty limits and tbis permit may be revoked at ar�y time upon violation of any of the provi�lona of eald ordinancea �� Buildin8 Inspector n NOTICE: Thb psrmN does aot corer t6s comlruettoe, IeshQaHoa fo� �rirfae, plumbtee, �n 6aMee, s�w�► or wahr. B� wn to a� tho Buildiap Impsetor far aparats psrm(ts Po� t6as tt�n». a S � •� � ,�1�' �,i%��to.!�T•e .S' , . • ,-. „ :(� . � , . : li r . � r '; d.e ; . �'� � tY • • . . . • +'• , . •.:'! .j, t . � . ;' . • t � i , ' .� • • �.. , � . , . . . ,�: . i - � � - ='. APPLIGAT��AT FQR:`�[iILD?N� PERI�IT � • . . . . � . , ' °. . �• � ,. � �:, � . . , . Cia`Y OF F1LiD'LEY, MIP�NESOTA . . . . t OWNER'S NAME � . '� � "t, ; , .� ...�: }ti . , $tT��.DER . Q:r; � �. , � _.�. Ann�^ss .' . ,�, �D�R�ss,,'��/%'.��: ��"� ._._ _ D `y .�_ w �� LOGATi01� OI�" BIIILDI�TG . _ •;�_- . .. ..;:, ;: . . NO.�� ST�tEET � t � _. �_,_�_ i�� c.�� `�p r•� _ � � � , , . . � •a f . �. �; � �LOT - � / I . •'-� . `-:B�OCK� �} ''' � � . �'" '' ADII�TYOD�, OR SU$l ,�iV�STON� ..�_..�._._._. : .r.._ . : . . ,,�' . , . .. � � F � . ..:. C�RT�R LOT `' � =7.NSIDE' LaT�„_S�ETBACK ��.� SIDE�'AIa � ��;�:�,.. , ,�'�'� r•'�, .'___.. SE[�1�R ES.EVA�ION TQP OF' FOOT�Nt3 ,, . � : � . � •' � :' � . . ' . .,..._. . .. . . „ , , • , . .{ , . Ap��.icanx �tr'ach ��to �tii�s 'form��Two Certificatas �o�; S`v�veq of Lbt �nd propos�d� � building lacatioa drawn on theae CertificaCea., � . . .. ' ]�LSCRtPfiiON OF B'UILDINQ '. '� " . ,} . ; ° � �`� % To Be Used Ae a , ' • �� . ' '• ' • � , �� ,� � , � Froat ��,�Depth .� fleight!_� �. , Square feet /1�� Cubic Feet • Pront- Depth fleight, Square feet Cubic Feet Type of Caastruction � Estimated Cost �� To Be Campleted ��I:� � , The undersigned hereby makes applicat3on for a permit #or the work herein specified, agreeing to do all work in strict accordance with the City af Fridley Ordinau.ces and rul3ngs of Che Department of Euildinga, and hereby decZares tbat all the facts and representations stated in this spplicatiou are true an correct. DAT�_ � _� _ SIGNAT'URE _ - _ - - _ . (Schedule of Fee Coats can be found on the Reverse Side). � .�� , '� �.s-�. � � A � ,,�c c � n�r sc.c . .. r �, .. � r ,. � , _�: . r - . . _ , . . .��: �:::� � � BUILAING PERrdIT FEE SCHED[]LE� . . . . �•� � • � SECTION 2. The�Inspector of Buildinga.,�h�ll, before issuing permitis for the erectiQn of, �n.y b.ui.ldiug-�or� structure, or f�or any addiCion to any � exist3ng structure or building, or f�r an�r„alCeration or,repairs Co any exi$ting,building�or�stt�ucture, upon application th�refore, require the � the payment by the applic�nt for ,�uch .pe�it of L�e'� to tlie ��raount herein below �et forth _and in the mauner �tierin 'prdvided to-wit: Uniform �uildia� Code: Tqpe 1, 2, � 4- .$1.,�� .�r •each� one thausand cubic feet,.; ex, fracti�� thereof, in suc'h cu`bi�al;,c,�n�ea�s; Type.. 3 6 5- $1.50 for . _ "_ � each one th�saad.. cutti� • feet .' � . `. . � ;; ,. Fsr the purq�oae ef �nmputing fe�a for building permits, the cubical eontents af anq building or addition t• a u�siform height thtQughout by ,�tu,�.tiplyir�g the groua8 area .covered �fr4nn° a°"'point six (6) iachea below the floo- . •- '��'line if til�e basemeat or the cellar te the average height of the up�er surf�ce or to,the•average height of the r'oo# su�face of the main gable of a . . . .. ..� . . pitched roof . . . F�r°repairs or a�teratioas�to an existing atructure, the.fee shall be at the rate.of $3,0� pez each,fiv,�•hundred dollars ($500.OQ) or fraction thereof �. in'the co�t sf all propos�d work. ,,. - � In��no ��§e shail tbe fee charged.for anp permi`t ae set forth ia Section 2 be leas tha� $S.AO. _... � .. . � . ... ' . . . .H :; _ . NSSSD ��nneetion Charge�� based �n locatien-�Ar�a 1 or 2. . _ � •;:�:. � . ° • . � .. :,: ,� : . �, .. . . •. • � �'> , :; + , . . . �� .��r•,.� • • _ . . � . � . �/'. v .. � @ � � • .. . . .�f .t. .. . . � ' ". • _= ' . . � . '. , ,!'. / \ . . . r.. . . �`a . .. � /: : . . . .. ` / 1 � � �;�a'Y . +, ... ,. �.,#;ro,.. : �� ''. , t�. ,.,.m �.. �:�,.�'9- a� ""'�'S.� t � 'i�''-�y ' . . � . . . ' y, s, v� 'w i, "� nt+ ,.y � Y FP �; ; �: . �#�1 h � . . . . t �+�' d IYr � _ � � � . � �� .� � �� s� EN�1l�E�Rl�Ci� t��. : ��? c�i b;� s�s� . E� . -- En9inee,rs= �� Su�veyors -- : +C '�C��e � .� �.: �r,#��-1 - — -- _ _ _. .- - - _. �r�r�' , - - � . . � � ; 5,� q ¢F..3� : �, ^. . �.t ��.. � t' � a �' �� ..r'' _ ; �",.>..F^_ �� a a:;. / �J �..OrC�� \ _ �� a � , * - � �, , �� o pElqTES IRON _�D£NOTES DRAtKAGE Al1D Utt�tTY E!►i�[►�NZ' LOT�.L,.._BLOCK�,2, Mti.ODY MANOR 3R0 AODITION AMOKA LI�R /�►�rdy � f�F �es s e iFur ad mr� �l'� �'a sr'N�/ 1�'�t �a�C ��Mr �► ui�e'+�'tr�,,� � �'i�t � �'irt' bre6lro�t . �, �nd� r�k e�vsra�s , � i.y. �► �rar��wd. b su�w� �{awe �i�'�.:� ,_� '�--�y�� .a bti�. . SU6UR8JW EN6��ltiiVt�,. 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Q. � y � ti bi � � Y � � a � � � � � � � � � � � ` � l, � b b b � S �' �' � � � � � � � � � � � � � � � o � � y �' R° � p O � ,�•�, � I � � cr b � $ a � � � ¢ fA . . en . . � o : : 0 0 . . 0Q . . 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FOUNT. s►+was. FLOOR DRAINS u� BASINS �uro v/wsr��ri GAS MPL GAS RANGE GAS OPENINGS +� • z • � � � A � � �a� � � w '�tl � �D � ��`°a � o c�o � �. 'Q �� °� �� y 7-i � � b � �b � � b p Y m o � ao p �'�,o � � � w a � �� o��'" #��y �� W� �. � � � ��o ..r',� a t�' � � .e � 3 `� � � �' d x� � ro a� � � �Z h°n p � M � �, �i � � � � � ��.� e ' � �. � O� � � ` : � ; O {0 � � � � a ,� `° � �� , � � � ro �p o � m � � � � � —�" �3 � G � R � 'd N o � p � : M . 7i : � . m . m . h ' o : a � . � : � � � Vi • 0 N � � � � � a � � p � � � c�'o � z G.�i � w z y� g��p x 8�, �� O � �f� �i: y � � N ��'��a o '� � m � p' y . `° � � � � � � ro � ¢ 0 � � C � . � � . � � . � O~. p � �' , fA � : : oa � : � °� : � Q : � . . . � $ . . . . : : : : hd : : : : : : : � : : : : � � � �a k aa �°1 �a x k�e x �e � ,c��i � ,t�.� � w � ,�ia � i,-�+ � ►A �� S�$ � g� o 0 0� �� .�� y �' � � � � la O x � � i 1 � D '='� rD- � --1 T :ii � 2 m C r m .�. • �P. w p M+ ai � a. a � � � � � 8 � � � � � � � p � � � � � �� 8 M I � ° m � a � f�D �p f� � I�-b � a � bd � 0 � � � � � w� ° � g � I Ch F� � ~ � 0 o t—� � � a � • Qo ro `— (y" � .� � �. . � '! WATER aosers URINALS ear►+ rues BAS�1� SINKS WASH iRAYS DRINK. FOUNT. sHwRS. FLOOR DRAINS cAra+ B�SINS AUTO W/�SHER GAS APPL GAS RANGE �� OPENINGS .. z e � � i m A rm- � � o.a� �� '� p, fD .i-' � N � w x �°N,�� p. °a `° � '9@ �.I y � 0 W � ��.oy � � �� N �ro� � � y � � �'ro�� '� � � o � �� p �y � o ��y�p ��o ��w � �.� �� o��" �� w�� w � O M � � �"' A '.± I � N 3 `� � � M W � C � � �� aM Rx �L M p � M � � � a W � = �i � � ` J \ � f� � - • � � � � \ o � M � � � � x �O N � � �- m � �� . �� c* 0 c� � �J'l N � � 1{ � ��rt V't N , . . , ��( ¢.o►:b �sp��c�r.1 -t424-- Cc..1C.ER'[a ST B. H. BRADLEY '. �,�,oLEV� ��i,�� GIV�L ENG�NEER AND SURVEYOR S'�,r��cy fOl'' %he S��sse l Co a829-247H AVENUESOUTH YINIVFAPOLI3. MINNESOTA SSt08l � /��O CD! / I Q I ' V�, ria-z�ea ' a � , �t Di1 .. , ' f5�'j� ` . /r .• t • i s.3' 2o.c� . � �a/F-/-�ZG o _ --2r3 `�' , �. ,4� ,,, ,. ,---"-- � _ � . N � �� , � t -. . � PRc�Po°.�= a � � � h�� 74� z ��' - o GA�� . - \ �� .3,�,�� ,,.,,,�/. _ �U - _ „ ?`� _ , ,�'4",. % �. - ► � . _ 4,2' • � o•�' � , � � � .. ,' 7, 1 � �;r 11 /i �r ) � � - � 6 �%l�i �� %~� ��i� j/� � . � _ • . 1'herehy cerfify ��at �h�s is ac��rLCfrEpreSen�nflG� afU S'G�N�yOf Eof /!, /j/ack 2, ��t�Joc�y l�'/c�nar 3�% /�c�difi�n, c�ssu�-veyed hy �rrE �� .�o � ��oy a f Ju�� y7�, , � . _ � % %��?� � c�G� � � , ��ey or' . .. _ ^ , � _ �.'' : HOUSE HEATING TEST RECORD ADDRESS —�,� �� APT. OOR—�- CI URB OC�CUPANT OWNER �-�'-�'�_ -- - - - � HEAT LOSS DATE HTG. INST. GAS C0. METER BADG # SOLD BY INSTALLED BY �C?��,L `� �e�� Elsetrical Work By Gaa Lins By "J ` v TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER '-�� GAS j�ESIG�� ` CONVERSION MAKE �'��-�� ,_(`° �/-� ��-�� MAKE OF BURNER Modal fE� Model Serial �-��" �°�- �` Max. BTU Rating INPUT l�_� MAKE OF FURNACE Model CONTROLS THERMOSTAT �Heat Plug Valve � Limit � -.� �� `�� Limit Sstting �� Fan Setting �;� �' �� Pilot Type Pilot Make -'�- Pilot Model Pllot Timing ��- Vent Size + KIND OF LINER ' ZE�NONE Draft Hood � Regulator Fi Iters Size Numb r Chimney Loeation Insida � Outside Chimney Construction Smoke Bomb Wiring � �� Drah � ��- Test Tag =� L.W. Cut Off t� poor Pressure_ Lighting Inat. Prossure -��- � P �enqt C� �� Date Tsated — Input CFH '� P�ct61S't ��'°'�� ' �Company Testing ' � ` Stack Temp. Percent CO `�� Name of Tsster Form 235 City of Fridley, Mirm.. BUILDING PERMIT Date: ��g.t�Inh��e 7.970 • . :f�. . ,R_ . -. � • R. � :t:1•: • �� < a- - , � - :.� • S � � . �► ' • � . -..,; : 1 • ii . � a_ , " - - T- -'� - - �� ,,1-._ - - �� loszs -��--_�-��" LOCATION OF BUILDING No. �424 S�t Concerto Curve N.E. p� af Lot � 11 _ glock 2 Addition or Sub-Divisfon .�.elody Manor 3rd Addition Coraer Lot — Inside Lot Sewer Elevation Setback � Sideyard ____ Founda.tion IIevation DESCRIPTION OF BUILDING To be Used as: A r�a�h $ � a�e Front �Z..2� . Depth � Height 1 �� Sq. Fk C,u. F't Front Depth FTeight Sq. F� Gti. Ft Type of Constructfon Frame �� $3, 500. 00 _ To be Completed 90 da,ys Provide Hardsurfaeed Driveway In consideral3on oP the issuaace to me of a germit to construct the building described above I agree to cio the proposed work in accardance with the description above aet f rth and in compliance with a'll provIsions of orrlinances oP the dty of Fridley. _ %� In consfderai3on oP the payment oE a fee of $ 9• �� , permit is hereby granted to Sussel Company to conatruct the bufldi�g or addition as described above. This �t is granted ugon the express conditfon that the persfln to whom it is granted and hia agenta, employees an worl�en, in all work. done fn, around and upon said building, or any part thereof, ahall conPorm 3n all respecta to the ordinances of Fridley� Minnesota regardiYg location, construction, alteral3on, maiatenaace, repair and moving of buildiugs witi�in the dty ]imits aad thia permit may be revoked at any time upon violation of aay of the provisiona of said ordinancea. --�� -L��Bl�ildtIIB Inspect�r HANK MUHICH NOflCEs This psrmit deas em eevsr t6s co�strudioe, InstallaHon fer whtne, plambWe, ga heNinB, sswee er watsr. B� sun te ses tha Buildiu8 lesps�to� fo� nparab Oarmhs Po► thess Itfma. ,,� �� , �1 , � APLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : � � s .e�' •�s ia � UILDER : o� �s � � � ADDRESS :_ %�a � �w! �E'��► � t° ADDRESS :_ ��.�d � e NO:. STREET: LOT :� BLOCK: � ADDITION :� Q �` �, tgy � d CORNER LaT: INSIDE LOT:�_SETBACK: SIDEYARD:� �r�' �' '�r','� af �� ° ' =� _ ;�' � � Applicant attach to this form Zt,,o Certificates of Survey of Lot and proposed buildiag location drawn on theae Certificates. BESCRIPTION OF BUILDING To Be Used As;. ��a.�; � �ront:_ 2� Depth: �� Height: /D Square Feet: Cubic Feet: Front: Depth: Height• Square Feet; Cubic Feet: Z'�ipe of Construction: �e��..�g,,,, Estimated Cost: $ 3S'�� To Be Completed: ��► � � � The uaderaigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work ia stfict accordance with the City of Fridley Ordinaaces and ruliags of the Department of Buildinga, and hereby declares that all the facts aad representations stated in this applicatioa are true aad correct. DATE : � �� .� .� /.k° :a � � S IGNATITR� : � � . (See Reverse Side For Additiorial ZnfosYnation.) , .- � ,._ .- ,� ,- ..� �' ,. , = ___ . : � ' � - ^ � BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erectioa of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to a.ay existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein belaw set forth and in the manner herein provided to-wit: � t-.. LTTTIFORM BUILDING CODE; Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical conteats. Type 3� 5-$1.85 for �' f� G each one thousand cubic feet. � s u ADDITIONAL INFORMATION = For the purpose of computing fees for building permi:ts, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average� height of the roof surface of the ma,in gable of a pitched roof. For repaira or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the coat of all proposed work. In no case shall the fee charged for any per.mit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a miniimum of 24 hours fram the time of application, to allow for proper review of the proposed sts�cture aad of the construction eite. A Certified Survey af the lot, showi.ng the location of the foundation, once it has beea constructed, will be required before aroceedin� with the framing. CERTIFICATE.OF OCCUPANCY Application for a Certificate of Occupaacy shall be made te� (10) days prior to the use or occupancy of any structure for which a building permit has been iasued; aad said structure shall not be uaed or occup�ed until a Certificate of Oacupancy has beea iasued. � � ! � �. � ��a / BLOCK ADD'N. ;� . �� NAME � `f � a��..i �'� r'�.�► � c� ADDRESS � � � � ��`� � + : AREA �►�t �.�. 1��-� �� SIZE �� Z� VALUE � ,�� TVPE �i�� ` ��°��.� ��y�� ,"�, �. *�! � � ��'�+� � ��: �e� �.;��`��,�'-�. �� 1�°*'�- . �� ,$� ��. � �,r � � .°` �, - - �. �� i�. �a o�:. � 4 �'�"t�, �..e�.,� � '�." ` � a'� � ��..�°'° � ��y'�' � *� �► '�a �� -�'°�!' � �i�"+g," a �� e�, 4 �� .`� �� i':� � � 1 � ;�;� �`-� "� �.� �, �1 t � � '� � ,4.��-:�1 b'�'a•"'"� �� , � � cd,� �'�` � f`�'. � � �jj� � �q.� '1z� %f�'� �°��. � INSTALL 1/�`�BOLTS 18" FROM EACH � A�� subcontrectors shall verlfy,and De responslDle for /�+ (�' Irvr+pp��1 all locatlons end conditions shoven by these drgwfngs. t,sORIVER G3�i,.EiT AS IVl/TED OR �Thisofficamustbenotifiedofanyveriationsorobstacle4 , If�D6�ATL� /al'1�D 6" OFF CL OF EACH to the P�oPosad work before procaeding with ANY. � 6 lnstailatlq� _ fa�6�l�{NI�1G VilALL. � - � ' • —_ �..,, .7 � s �.�"'�. ,�°" su9��Gr City of Fridley 3114 5 AT TFIE TOP OF THE TWINS � � I L D 1 N G P E R M I T � � � COMMUNITY DEVELOPMENT DIV. RE A/� Q/� � • f � y � � PROTECTIVE INSPECTION SEC. �/� �� i = � � �"'� � CITY NALI FRIOLE� SS1�2 NU48EP pEV DATE VAGE Oc �6vROVED Br �---•� � �'� 612-571-34b0 91Q-F15 7��%a� / / �oe aooaess �424 Concerto Curve NE 1 LEGAL �OT NO. BLOCK TfiACT OR ADDITION SEE ATTACMED DESCFi. ].1 2 Melody Manor 3rd SMEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Greg Bogut 7424 Concerto Curve NE'`' 763-717-0172 3 CONTRACTOH MAIL ADDRESS ZIP PHONE LICENSE NO Renewal b Andersen 350 - 73rd Ave. NE Fridle I�IlV 55432 502-4777 20130983 d ARCMITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL AODfiESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFK O NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE B DESCRIBE WOFiK Window Replacement 9 CHAN(3E OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all ievels of the dwelling per Section 310.9.1.2 of the 1997 Uniforn Building Code. Permit Inspection Card� �►i�A �a INailed �'o� Horneo�ener T� �Post SEPARATE PERMI7S ARE REOUIFED FOR EIECTFICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO VENTILATING OR AIR CONDITIONING. 7MIS PERMIT BECOMES NULL ANO VOID IF WOFK Oii CONSTRUCTION 20NING SG. fT CU fT. AUTHORIZED IS NOT COMMENCED VyITNIN 80 DAYS. OR IF CONSTRUCTION OR WOFK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WOfiK IS COMMENCED. NO. DWLG. UNI7S OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE REAO AND �XAMINEO THIS APPLICATION ], STA�LS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED WITH WME7HER SPECIFIED MEREIN Oti NOT. TME GRANTING OF A PERMIT $3 115.00 .��..SC DOES N07 PRESUME TO GIVE AUTHORITV TO VIOLATE 01i CANCEL TME pEqMIT fEE SAC CMAFiGE PqOVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• STRUCTION OR TME PERFOflMANCE OF CONSTRUCTION Q%e 2S Fir . SC $3e �.Z PLAN CNECK fEE TOT FEE Lic s SC 5 0 106.93 S�GNATUAEO�CON'AACTOpONGUTMppIjEOOGENT �DAiEi N PROP VALID TE TNIS =R P RM� / S�GNATUAE O� OWNEQ i�� OWNEA BWIDEAt iDATE� ` OG �tiSo r��rt �[ ] A�DN �� Effective 5/10199 [ 1 � oF �i.� [� �r�a.� ��.� � ��g.�.s � � asr� � 2 I.E BUII.,I�ING PERD�IIT APPLICATION � � . � .. � • � � �, . ./lI ' ,i( _L�' L / � �� ia - - �- ��.� , � � � - , �� - : - . . - i �'I �L.., - � !..�1� ,/ r' " � I � i _ j _ - �� . • . . i_�L�. !1� ' . �i .� -�� ...._ I � s • � � . Address: lot, wit�i the�proposed�constr�ction dra.wn on it to scale. � ;. s;� � �: a �• � e ra� Tel. # _ ,�oZ' ��%'7 LIV�TG AIt�A: Length Wi�th Height Sq. Ft. GAItAGE A�A: Length , Width �Height S�q. Ft. DECg AItEA: � Length ��Vicitli HgtlGround Sq. Ft. 01'HEit: . � � �o��on T�: . �� ost: � � , II.S Driveway C�rb Cut V�idth Needed: Ft. + 6 Ft = Ft x$ _$ - DA�: � �2'�.� � APPLI��: ` � Tel. # S�''�� AP g crr� us� orr�x Permit Fee Fire Surcliarge State Surcharge SAC Charge License Surcharge Driveway Fscrow Erosion Control Park Fee Sewer Main Charge TOTAi, � � a� $ � /� � 1. 5�� $ $ ,..�.�D $ $ $ $ Fee Schedule on Reverse Side .�1 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State I,�cens�d Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineeri.ng Agreement Necessary [ ] Not 1Vecessary [ ] � o�� . s�uLa�aoNS:` ��v�r�� s �� d�v��V� li r� � � �� ,��.��v�.r� �� - 1�� .� �, �,��°„�G i� �,�'�1� ��.. -� ' t r- � ' � � t ;� :,i �_r The Chief Building �fficial shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or struct�re, or for any alteration o� .r�pair to any existing building or structar�, upon application therefore, require the .pay,ment by the appliEant= for.�su�1� permit:af €ees to the amount..herein beiow set forth and in the manner herein provided-�o-wit: - - - _ TOTAL VALUE $i to $500 $501 � to $2,000 $2,001 to $25,�0 $25,001 to $50,000 $50,�1 to $1�,Q00 _ . ___._._... - FEES $23.50. . : $23.SD_for first $5�°pins: $3.OS for each additional $1� or fraction thereof, to a�d�:inclnding:.$2;(-�Q _ . ... :.,$69,2� for first �2;.(�O, pl.,u�. $.14,�:fas each additional $1,�D00 or fiaction thereof, to and including $25,000 $391.25 for first $25,0� plus $10.10 for each additional $1,OQ0 or fraction thereof,. to and: inclu�in� $50,�0 ... $643.75 for first $50,000 plus $7.00 for each additional $1,�0 or fraction thereaf, to and including $100,000 $lOD,�l to�$SOQ,OQO �993.75 for first $100,� pltys $5.60 fo� each additional $1,0� or fraction t�ereof,� tc� and 'urciuding $��,000.. - $500,001 to $1,�,000 $1,0�,001 and up $3,233.75 for the first $SQO,Q00 plus $4.75 for each additional $1,�0 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1�,000,000 plus $3.15 for each additional $1,�0 or fiaction thereof ` � I)RNEdVAY DEPRESSION ESC1tOW (Concrete C�rb Streets Only) Alternate "A": Remaval and replacement of curb and. gutter only - Driveway width plvs 5 feet times $15.50. Alternate "B": Removal-and replacEment o€ curb and gutter and:in�a�i a 3 foot�wide: •° -- approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VE�FICATION OF FOUNDATION A Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. �� A Cer 't�f'icate of Survey of the lot, showing the,location of the foundation once it has it has been ��d will be required�before proceeding with the framing. � ..�... .� „ CITY OF FRIDLEY 6431 ITNIVERSITY AVENUE NE FRIDLEY, NIN 55432 572-36U4 FAX: (763) 571-1287 � .� PERMIT O.: 2004-01194 '� DATE ISSUED: 07/28/2004 ADDRESS : 7424 CONCERTO CRV NE PIN : 113024130071 LEGAL DESC : MELODY MANOR 3RD ADD : LOT 11 BLOCK 2 PERMTT TYPE : BUII,DING PROPERTY TYPE : RESIDENTIAL CON5TRUCTION TYPE : RESIDING VALUATION : $ 8,800.00 NOTE: INSTALL BUII.,DING WRAP AND SOFFIT VENTILATION PER 2000 IBC. REMOVE EXISTING SOFFIT IF NEEDED. RESIDE HOUSE & GARAGE, REPLACE SOFFIT & FASCIA. STATE LICENSED CONTRACTOR 1 APPLICANT MINNESOTA EXTERIORS INC (2877) 8600 JEFFERSON HWY P OSSEO, MN 55369-0266 (763) 493-5500 OWNER BOGUT GREGORY T 7424 CONCERTO CRV NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or constntction authorized is not commenced witin 60 days or if construcrion or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and l�ow the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law r a construcrion or the erformance of construction. � P Applicant � Date�L Bldg BUII..DING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 138745 SEPARATE PERNIITS RE�UIlZED FOR WORK OTI�R THAN DESCRIBED ABOVE. 167.25 8.80 4.40 5.00 185.45 NEW ADDN ALTER ,�� 8� [] CITY OF FRIDLEY Effective 4/1/2004 [] 6431 University Ave NE, Fridley, MN 55432 (763) 5T2-3604 Bldg Insp [ j SINGLE FAMILYAND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION r._r/1 i /i c _ ��`� ° ��J �� Construction Address: Legal Description: Owner Name & Address: Contractor. Address: , LNING AREA: GARAGE AREA: DECK AREA: OTHER: Te�. #P763 -7/ � -U/ '7 � MN LICENSE # � L� — � `� 7 �� Tel. # 76 3 ��/ �fSl� Attach to this application, a Cert�cate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. � �� Construction Type: � '' �� Estimated Cost: $ � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ � DATE: �� D APPLICANT: Tel. #%C-� 3�� '�f �� Call (763) 572-3604 for Permit Fees ff mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TC � �� 7 �� $ $ -�� ' `�� $ $ �° d?� $ $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ 7 � J STIPULATIONS: � Z�/ !�%�� > S�� j��'/s-��— �G� /� pl��a� t _. BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing perm.its for the erection of any building or structure, or for any addidon to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $5(� $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3 .OS for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,�0 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $SO,Q00 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,OQ0 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,OQ0,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete C�ub Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate Pernuts for consixuction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Cert�cate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv _ . F, ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CITY OF FRIDLEY 6431 UNIVERSII'Y AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 : 7424 CONCERTO CRV NE : 113024130071 : MELODY MANOR 3RD ADD : LOT 11 BLOCK 2 : BUILDING : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL \ PERMIT O.: 2004-01245 DATE I5SUED: 08/02/2004 VALUATION : $ 8,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENII�TGS. REPLACE 7 WINDOWS WITHIN EXISTING OPENII�TGS . STATE LICENSED CONTRACTOR 1 APPLICANT RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C ROSEVILLE, MN 55113- (763)502-4777 OWNER BOGUT GREGORY T 7424 CONCERTO CRV NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions o any o r state or local law regulating construction or the p rforman e of construction. Annlicant /1 _ Date / / Bldg BUII.,DING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALLTE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 36365 Permit �n��ction Cards Wil� �� Mailed �o Har�eo�n�r To Post SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 153.25 8.00 4.00 5.00 170.25 04/02/2004 FRI 13: 21 FA% i-�� ELDER JONES %J�' 6�� [�7j 001/001 F- �• . . �c�°��-��-f�� . .. .... N� [] CITY OF FRIDLEY Effective 4/1/2004 ADQN [ J 6431 University Ave NE, Frid.ley, MN 55432 (763) 572-3604 Bldg lesp �-� [] SINGI�E FAMILY AND DUPL�5 R-1 AND R 2 (763) 571-728� Fax BUILDING PERMIT APPLICATION Construction Address: �' �i o� �-i C. 0 rR C� t� C,�x v.�„ N�L., Legal Description: � Owner Name 8� Address: C� a.s 13 0�v.�. Tel. � Co5 I-� t}- 01 �c'7 Contractor. MN LICENS�# o�O��J' O9�?J Address: ��W� BY ANDERSEN Tel. #�S I' c. {p�, � y�'�' T 1920 COUNTY ROAD "C" WEST ROSEVII�L�, MN 55113 ��te of Survey pf the - ,� drawn on it to�sc��:� � LMNG AREA: GARAGE AREA: DECK AREA: OTHER: D�SCFt1PTlOh1 O� il'IilPR�1/EMENT Length Wid� Height S�p. F� �� Length Wdth Height Sq. Ft� ��'°° ,` Length �dth HgtlGround Sq. Ft J � � „v � Construction Type: Estimated Cost $ g` nCY� � priveway Curb Cut Width N�ed�d: Ft + 6 Ft = Ft x$ _$ � DATE: � S�1 u b�°1 APPLICANT: I'1 __�...Q�npa � Tel. # 9S �- 3 4S- [0 O N�}- Call (763) 672-36Q4 for Permit Fe� if ma�Ting in application. Fax to 763-57'I-'f2 7 if usirtg credit card �1td we w'itl call you for card number. "'� � Permit Fee Plan Review Fire Surcharge � State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer �Main Charge T07AL CITY USE ONLY - $ l 5 . a� Fee SchedulE on REVerse Side � 65% of Permit Fee $ �. 0 b .001 of Pennit Valuation (1 /10th%) $ �. oo � $.50/$1,000 Valuation � � $1350 per SAC Unit $ s, bC� $5.00 (State Licensed Residential Contractors) $ Alt "A" or Alt. "B" Above � $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreem�nt Necessary [ ] Not Necessary [ ] $ ��- 0 ZS . . STIPULATIpN�: s CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 - �=--__ PERM N0.:2004-01437 �' DATE ISSUED: 09/Ol/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 7424 CONCERTO CRV NE PIN : 113024130071 LEGAL DESC : MELODY MANOR 3RD ADD : LOT 11 BLOCK 2 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDTTION/ALTERATION VALUATION : $ 3,500.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL THREE FIXTURES IN BASEMENT BATHROOM. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES � # OF NEW FIXTURES 3 VALUE (FOR MINIMUM CALC) 3500 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 0.00 FIGNAR BILL PLUMBING PLBG FIXTURES (NEW OPENINGS) 30.00 2844 JOHNSON ST NE PLBG FIXTURES (EXIST OPENINGS) 0.00 MINNEAPOLIS, MN 55418- WATER TREATMENT APPLIANCE 0.00 (612) 788-4288 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 BOGUT GREGORY T PLBG REPAIlt/ALTERATIONS 0.00 7424 CONCERTO CRV NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 30.50 PAID WITH CHECK # 39869 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and lmow the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of � other state or local law regulating constructi r the p rf ance f constructio . 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BI�ADLEY '. �,o1.Q►�;� h�i�,1k3 CR/IL iN41yE'ER MND QURvEY9R � iass.aa,,.,�v,uvv��a�s►e �Vi�1/�y ��r %he Susrel Ca M►�uw.or.►e. uwr�bor� a.ca I , . riy-Y�� 1 r�SO Cornv �v�. . � t a' � ��"�� er�ta �� t 13x �e ��t� � - � t, ' 3 -� �a�t N � \ ~ � • 4 f� � / � � ', ��OnC�o�S`i �_ C p �A�� . � 74 L �'r � .. �. � +1�lJJ S �.6LLL11LU7(r.G:. 2� o•�� it �� .0 h ti. 1 9_ .. �� . 0 P�GE 04 P. 02 ��i� � �a% � /-�2 L' . � � �.''.!f ) I � . � ff>/YCE�C'TO tU�C ✓,� , Ihe�q�y cC-��ify �ho! rl7is %S o' G'G�'r•:.-��pr�S'�.7Iri1`i✓� ofu' f'c.�rv�y of Let /!, . F}/ock 2 n��I�d� N/c:�•,-,o.- 3� f-�c/di�r'�n aJ su�,r ��d hy ,�� .�o� �oy �� .ru�,� ��, . . . � ��%�.�s�'� _ . �r��•�y �r. �: - � 0 0 . . ; r � f� � Building Inspections 763-572-3604 763-502-4977 FAX DATE Li� � !i s V SITE ADbRE5S 7 uE Z TH1S APPL(CANT IS: PROPERTY OWNER/ TENANT SUIIMIT A COPY OF YOUR STATE LICENSG AND CERTIF[CATE 0� lTISURANCE PROPERTY TXl'E TYPE T1'I'E OF PPSCRIBE WORK BEING D{ SIZ.G OF lMPROVEMENT ROQFING NUMB$R OF SQUARES _ GAIiAGE5 PRpPOSED S72E: PROPOSBD HEIG1iT: From: unknown Page: 1/2 Date: 2l12/2010 2:33:47 PM �UILDING RESIDENTIAL APPLICATION CITY QF FRIDLEY YOUR E-MA[L ADDRGSS S ICJ hJ �WNFR OCONTRACTOR Permit No.:�! 0 �/�� Received By: 1-g Date Rec'd:� 1 i ��%1 [� 4 yt�'� IVAME�'7, !!LZ��-� 5 ��,�... �: v r� AADRESS: 'J�? 4� �_�„� (t.�rtl� GTY %Gh�� STATG i�ZiP 1'HONE: ?�'� �� Co0 (vZ 3VAME: STA1'E LICENS[ H EXP DATE ADDRESS: CITY STATG ZtP [�SlNGLE FAMILY/NS4V CpNSTRUCTION D'fW0 FAMILY/NEW CONSTRUCTION F1NiSH � ROOF O SIDINO 0 NL-W FiOME CONSTRUCTiON Ct MAfNTENANCCJRGPAIR FAX SIZC 5TORiES�T JSHED O WINDOWS O DRAiN TILE ❑ pTHGR NG POOL 0 ADDITION REMODELING7 f�G�p/,w3�1�� : WiDTH� �I,[7 HEIGHT (7 HOUSE ONLY D HOUSE & GARAGE ❑ A'i"I'ACHEI} GARAG6 O DGTACHED GARAGi I°I' �'i� � pASEMEi�lT REMODEL:IiVC tt tRMrr• 1. E�isting Pfoor Plan 2. Proposed floor plan 3, List of suucfural members to he used ID1NG FOR NEW CONSTRUCTION 1NCLUDING DECKS, 0 Vinyl pgp�� ADDITIONS & POR�HCS SUBMIT• O Aluminum O Trim 1. Site Plan/Survey showing thc exisG� stn�ctur� O Other ❑ Fascia and proposed project. 2, T�vo seu ofconstnulion nlans ��n`� �;' 3. Gaergy Calculations IN EXISTING OPEMINGS DYcs CJNo LOCATION OF WINDOW5 FOR WINDO\i'S — PI20VIDE U-VALUE AND Olt FOR NEW OPENINGS-DGSCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW, OPENINO CI�IANGES R TYPC OF W11dDOW TO BE 1NSTALLEb NUMDER OF WINDOWS ALL FEES ARE BASqD ON VALUATIUN, iNCLUD[NG THE COST OF LABOR AND MATERIALS: �SINC TNE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB ��ALUATION � � �(� _____, _ OCCUPANCI' TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Sorcharge SAC Charge Curb Cut Escrow Erosion Control Park 1=ee Sewer Main Ciiarge Tofal Due $ $ $ See Back Page for Fee Schedule 65% of Building Perntit Fee .00I times the tatal job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residentiat Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $45d Conservation Alan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks navable to: C1iv of Fridlev Atrae '1TaIS IS AN APPLICA'fiON rOR A PL•RMIT-NOT VALlD UN7'IL PRaCESSED 1 hereby appiy for a building permit and 1 acknowledge that the information above is complete and ac�urate; that the work wi}I be in conformance with the ordinances and codes af the City of Fridley and with the Minnasota Construction Codes; that i understand this is not a permit but anly an application for a permit and �vork is not to start withouE a permit on site; that the work will be in accordance with the approved plan in the case of ai �ork whic 1e r ew and approval of plans. / , / StGNA'!'Ult� OF APPLICA _.�� -�'_/�' PRINT NAME s'�'�"�' 1 C�INA AATE l. "' ,`"' ``� � �� l� � � � � � � � �� '' � - `� � � _ �`� -5. `�S . w�� a'P��''� ,�.,�.�-��,5 _ _ , From: unknown Page: 2/2 Date: 2/12/2010 2:33:48 PM � y� �� . � � .'_' �C�U t �,, � � '�- Sc� � 5u�� . �1 d � ��-k, all r�n��. �°c�uv�s � — ' �`vv�� C�V l � 5 lIJ �� p� . ,�o� ��oQ �� - �� - ��b � _ ,��,h . � �Qv� SEC R106.3.1 �� 1 �� .4,��`� . � �� ' S � �S �2�, .� ��. �°� `j° s'' &� ��"'" r � ; �r� 0�1. � � N,, �. �� `T�� -� '�� A � — pv� �� ib Fe � � � � ` � � �rv` 1 �� S � ��` = 1 ._-�-- — - �� 5�� TOR �''i'G'Qi'r" F.oZ�' � "P : � � � a" BLDG NSPE � $�tt��..v�- j - �i��,� � ' �'��-2, _ �O�s �N �� s�� c �;►�(�� d -�-� � � . �, �.c� (��L( � ,�� . s o. ,� � 5�.� s�-�- . Z��' — Ga ��-�� _ . � . � _ „��N �-5 ��S � �.' `�� aQ� R� � c�-�-�.-�.�.5 s 1 _ rrom. unKnown rage: u� uate: u� ��u� u�:ss:4ts rnn '� y�� (,,,��t-�.� Z�` �.-. - — � ��S 2�, S � � . �j� � co� S� � � � �� . � � � �, � � i� sc �+v o1J , � '�v�;� � i'� P..�1 �) � �(�� a� � hn�O �J �aduv�s .. — �. vv� � �A v'^�'� . ��,�,�iQS `N _ 0 �� ' �l�- _ ��,� _ ,r�K. h , , �c�u� SEC R106.3.� �� ,, ,�,�� _ � N., � �� `T��l -��, I�� A � _' p�� ib �e � � � ` � � �a�� s' �� N�i S %k� �� , — 1 —._._ ��5 � SG.�,�d- �? �,L '�� '�i�c�e�-- �i� �,� ;1, �, �- BLDG NSPE TOR � $�c`'�.v �. � , �, � �, � �� — c;r��. d, -��o�.S � N�� in S� �� c ��c� �q,�, c�, EQc.� f �vt� � � � - — C a��.� � c� �ct. S�-� 5�-�- .�.� R' . s�'o. 1= � �uilding Inspections 763-572-3604 763-502-4977 FAX �Y��G fl�S�E1�T�'�L �PI.ICA'�'��1lT ��Y �� EFFECTIVE 7-1-2010 DATE P O � I S� ( O YOUR E-MAIL ADDRESS SITE ADDRESS '7 �E �.'i� C b r, ��„� � a Cu►. K,. v� � E THIS APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMTf A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERNIIT TYPE �E oF wo�x: Permit N •- -. : �, �- �-� i�� .,� ,.; � NAME:��, 1 c� r. �`C l..l�. l ADDRESS: °I �'I e��F l�Ov� i,)ti�0 CU.�t-l/t�CITY �`E.t d�t... STATE��ZIP 55�13 \, PHONE: 7�3� %US� (o �` Z STATE LICENSE EXP DATE STATE BOND # EXP DATE ADDRESS: �e�-i ��G-�-� S�• A+� CTfY �1�, �DIti. STATEH*� ZIP SaT PHONE i`3 7 S� � l Q q FAX �SINGLE FAMILY ❑ NEW ❑ TWO FAMILY ❑ TOWNHOUSE J�REPLACEMENT DETAILED DESCRIPTION OF WORK �y� ��,� � I l�,p ��. c�.•�+ �.�� w y� ��,s�, �ti FEES ARE BASID ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI�. MINIMUM FEE $35.50. BATH SINK/LAV FLOORDRAINS SHOWER WATERPIPING BATHTUB GAS PLPING (NEED CITY LIC) SWINIIvIIlVG POOL WATER SOFINER ($3� _ CLOTi�S WASHER KTI'CHEN SINK WATER CLOSET BACKFLOW PREV. ($I S) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35) FOR IILRIGATION _ WATER METER _ OTI�R THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing pennit and 1 acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved ptan in the ase of a11 work whic � requires review and approval of plans. y� SIGNAI'[JRE OF APPLICANT' �LI r� J { PRIIVT NAME C;l.t_ il e.a (C e..,O,n DATE � O� i�i •! a APPR(1VA1. iNSPR(:T(1RS ST(TTATiiRF f.._ . ' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, NiN 55432 763-572-3604 FAX: 763-502-4977 � , ` ` tsuuwng 1��.;.�1�� Inspections ��I�� PI�I��1� 763-57?-3604 �� . �� 763-502-4977 �A� ��c�,_� �o�o DATE / U- ($.. � O YOUR E-MAIL ADDRESS STTE ADDRESS _ THIS APPLICANT IS: PItOPE%t'I"s� OWNE�2/ TENAN'T CON'Y'i2�,C:'i'OR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYP� '�'YPE OF WORK: ■ • ,�►I�• ADDRESS J�Z:ONTRACTOR " • � s ,�� - -. ; � L ! .�; ":fi ��- ��, - �� ; ; � 1'C. �.�t+ I ' Ce v. t �� o Cu.�e. �r�.. CI'I'y ��a. � a 1��, STATE M z� �s�a.L Pxot�rE: "7 63 •� 8 S- 6 � 6 a COMPANY NAME: (G� v � v CONTACT PERSON: C 1.� � t v STATE LICENSE # EXP DATE ADDRESS: B e1.4 O T� 0- �-- S� � CJ CITY FK. l W C� STATE�ZIP � s� 3 i- PHONE ��a � s u_ a�� F.� �SWGI.� �AMILY f] TWO FAMII,Y ❑ rr�w �'x�Lacnv�rrT � TOWNHOUSE ❑ ALTERATION/REMODII. DETAILID DESCRII'TION OF WORK � r S�i �a ( � (Z� o� e. cr� � �..�' �l� e. v► A Q�- `�- /S �� C b a dc� l�— FEES ARE BASID ON $10.00 PER FIXTURE, EXCEPT VYHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BFLOR�. PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASSRAE HANDBOOK EquipmentInsTalled MFG: rLe.... w� MODEL: �-G�n l�` �rIA�S SIZE/B'T'U a�w� Iv1FCr. 2v v va MODEL: U A Pr1 ' O•�-� af �2-- SIZFIBTU e�To h MFG: MODEL: SIZE/BTU �,A/C $25.00 _FIItEPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 AIIt TO AIIt EXCHANGEER $15 _FIREPLACE (WOOD) �35.00 NEW GAS GRILL $10.00 BOII.ER �35.00 �F[TRNACE $35.00 GAS L7NIT HTR $10.00 CHIIvII�1EY L1NEit $10.00 GAS DRI'IIt $10.00 POOL HEATER $35.00 DUCT WORK S 10.00 _GAS PIPING $lO.OD VENTILATOR $15.00 THI3 IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 3 ac?cnowledge that the information above is compiete and accurate; that the worlc will be in coniormance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is �ot a permit but only an application for a permit and work is not to start without a permit; that the worlc will be in accordance with the approved plan in the case of all worlc 1Nhic:� requires review and approval of plans. SIGi�1ATUP..°.. i1F t�PPLIC.�lT .�.PPRO�J.'�1L, INSPECTORS i�T,F � � A'�iOT'�:.. NAIvIE �� C1'�� flt"� �r��r �a��µ�� I��.�� e��.:r+�nf��n� �� u1�1"Ta� Sit;� ��e �ue i�i� Fz:ci:ey, i��i � 5�� _ i ��-��7? �oC�--'. �� i:s: 7E�-5+i?-=:9i7 TE �b=(S_.(J